The knee and what is its function?    

The knee is a joint which has three parts. The thigh bone (femur) meets the large shin bone (tibia) forming the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third joint, called the patellofemoral joint.

The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (curciate ligaments). These ligaments provide stability and strength to the knee joint.

The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for the joint to move on. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.

The knee functions to allow movement of the leg and is critical to normal walking. The knee flexes normally to a maximum of 120 degrees and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding surfaces for the tendons to reduce the force of friction as these tendons move. The knee is a weight-bearing joint. Each meniscus serves to evenly load the surface during weight-bearing and also aids in disbursing joint fluid for joint lubrication.

Knee Pain there are three compartments in the knee joint

Knee pain can be caused by injury, degeneration, arthritis, infrequently infection, and rarely bone tumors. The knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affects various tissues of the body including the joints to cause arthritis.

Ligaments within the knee (cruciate ligaments) and on the inner and outer sides of the knee (collateral ligaments) stabilize the joint.

Surgical repair of ligament injury can involve suturing, grafting, and synthetic graft repair. Routine x-rays do not reveal meniscus tears, but can be used to exclude other problems of the bones and other tissues.

Knee Injury and Symptoms.

Knee Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones forming the joint. The design of the knee joint and that it is an active weight-bearing joint are factors in making the knee one of the most injured joints of the human body.

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Ligament Knee Injury and Treatment.

Trauma can cause a severe injury to the ligaments on the inner portion of the knee), the outer (lateral) portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate knee pain, but are difficult to localize. A collateral ligament injury is felt on the inner or outer portion of the knee. A collateral ligament injury is tenderness over and around the area of the ligament involved. A cruciate ligament injury is felt within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is painful and may be swollen the knee pain is usually worsened by bending the knee, putting weight on the knee, or even walking. The severity of the injury can vary from minor stretching or tearing of the ligament, such as a sprain to severe and complete tear of the ligament the knee can have more than one area injured in a single traumatic event.

Ligament injuries are initially treated with ice packs and immobilization, with rest and elevation. It is generally initially recommended to avoid bearing weight on the injured joint, and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries. Cold or Low level laser therapy, has a five star rating for treating  knee inflammation, injuries and Conditions, by accelerating the healing process, thus reducing both pain and convalescing.

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What is Prepatellar Bursitis or (knee Bursitis?)

Prepatellar Bursitis, also known as housemaid’s knee, is a very common cause of swelling and pain on top of the kneecap. This condition is usually associated with carpet fitters because of the extended periods of time spent on their knees.

Bursa – what is it? 

A Bursa is a thin sac of connective tissue filled with the body’s own natural lubricating fluid. This lubricating sac allows various tissues such as muscle, tendon, and skin slide over the bone surfaces without catching. The Bursas are very thin but they do present a potential site that can become inflamed and irritated. This condition is called Bursitis.If inflammation of Bursa is associated with a break in the skin and trauma, the Bursa can become infected, this is called infected Bursitis.

The Symptoms of Prepatellar Bursitis or knee Bursitis includes:

• Swelling over the kneecap
• Restricted motion and knee pain
• Knee Pain with movement of the knee

The swelling of the knee is caused by swelling of the Bursa, not the knee joint itself. This swelling on the knee joint is commonly called “water on the knee”, but it is important to differentiate fluid accumulation within the Bursa versus fluid accumulation within the knee joint. These are two different conditions

Symptoms of Prepatellar Bursitis are usually aggravated by kneeling.

What is the treatment of Prepatellar Bursitis (Knee Bursitis)?

Treatment of Prepatellar Bursitis begins with rest and avoidance of activity that aggravates the condition. In some individuals, drainage or excision of the Bursa may be called for. In cases of infection, antibiotics are also prescribed.Bursa drainage can be performed by using a needle and a syringe. The fluid can then be analyzed to detect possible infection. If the fluid continues to accumulate, excising, or removing the Bursa, can be considered. This procedure is performed as an outpatient at the doctor’s surgery or local hospital. Laser therapy has proven to be extremely affective in management of prepatellar bursitis .

( View our Cold or Low Level Laser therapy section under Pain Relief ). 

Patellar Tendonitis (Jumper’s Knee).

What is jumper’s knee?

Jumper’s knee, also known as Patellar Tendonitis, is a condition caused by inflammation of the Patellar tendon, which connects the kneecap to the shin bone (Tibia). The condition is caused by overuse of the knee joint, for example, by frequent jumping onto a hard surface.

What are the symptoms of jumper’s knee?

The symptoms of jumper’s knee may vary significantly among individuals. The symptoms may include:

• Tenderness and pain around the Patellar tendon
• Swelling
• Pain with jumping, running, or walking or any leg movement.
• Bending or straightening the leg will be painful.
• Tenderness behind the kneecap  

Jumper’s knee diagnosed?

The diagnosis of jumper’s knee is usually based on a complete medical history and physical examination.
Sometimes the x-rays are performed. 

Treatment for jumper’s knee:

The treatment of choice for jumper’s knee is an avoidance of any activity that may cause or aggravating the condition until the injury is healed. Other treatment modalities may include:

• Anti-inflammatory medications
• Rest
• Ice pack application.
• Cold laser therapy is very successful and effective in reduction of swelling and promotion of healing
• Stretching and strengthening exercises

(View our Cold or Low level laser therapy section under pain relief).

What are the common knee problems?

Many knee problems are can result from continual wear and tear and continued stress on the knee joint; other knee problems result from an injury or a sudden jolt or movement that strains the knee.

Common knee problems include the following:

Sprained or strained knee ligaments

Sprained or strained muscles.
A sprained or strained knee ligament or muscle is usually caused by a violent blow to the knee, or a sudden twist of the knee. Symptoms include pain, swelling, and difficulty in using the leg while walking. 

Torn cartilage

Trauma to the knee may tear the Menisci (the pads of connective tissue that act as shock absorbers and aid in joint stability). Cartilage tears will often occur with sprains. The wearing of a brace during an activity may protect the knee from further injury.

(View our Cold or Low Level Laser Therapy Section under Pain Relief). 

Tendonitis.

Inflammation of the tendons can result from overuse of a tendon during sporting activities such as running and general athletics. Tendonitis of the Patellar tendon is called Jumper’s knee. 

Arthritis

Osteoarthritis is generally the most common type of arthritis that affects the knee. Osteoarthritis is a degenerative process where the cartilage in the joint gradually wears away, Osteoarthritis may be caused by excessive stress on the joint. Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. 

Knee bursitis

Carpet fitters and other people who spend a lot of time on their knees often experience swelling in the front of the knee. The constant friction irritates the lubricating sac (Bursa) located just in front of the kneecap (Patella). The Bursa enables the kneecap to move smoothly under the skin. If the Bursa becomes inflamed, it fills with fluid and causes swelling at the top of the knee. This condition is known as kneecap (Prepatellar) Bursitis.

 Symptoms.

• Pain with leg activity.
• Swelling on the front of kneecap
• Tender and warm to the touch  

Treatment

First recommendation is an X-ray to rule out the possibility of a fracture. Non surgical treatment is very effective as long as the Bursa is simply inflamed and not infected. Discontinue from activity which aggravates the condition until the Bursitis clears up, and rest the knee.

• Apply ice regularly, 8 times a day for 15 minutes at a time. This should reduce swelling considerably if the knee is also rested.
• Elevate the affected leg as much as possible.
• Take an anti-inflammatory medication such as aspirin or ibuprofen. 

(View our Cold or Low Level Laser Therapy Section under Pain Relief).

Goosefoot (Pes Anserine) Bursitis of the Knee

Pain and tenderness on the inside of the knee, approximately 2 to 3 inches below the joint, are symptoms of Pes Anserine Bursitis of the knee. The Pes Anserine Bursa is a lubricating sac located between the shinbone (tibia) and three tendons of the hamstrings muscle at the inside of the knee. Because the three tendons flare out on the front of the shinbone and look like the foot of a goose, Pes Anserine Bursitis is also known as Goosefoot Bursitis.

Risk factors

Bursitis, an inflammation of a Bursa, develops as the result of overuse or constant friction on the bursa. Pes Anserine Bursitis is common in athletes, especially runners. Several factors can contribute to the development of Pes Anserine Bursitis, including:

• Poor training techniques, neglecting to stretch before starting exercising or running longer distances.
• Tight hamstring muscles.
• An out-turning of the knee or lower leg.
• Osteoarthritis in the knee.
• Medial meniscus tear.  

The symptoms of Pes Anserine Bursitis include:

• Slow developing pain on the inside of the knee in the centre of the shinbone, approximately 2 to 3 inches below the knee joint.
• Increased pain with exercise.
• Symptoms may appear to be those of a stress fracture, so an X-ray is usually required.  

Treatment

• Discontinue all vigorous activity until the Bursitis clears up.
• Injection – Your doctor may inject a solution of anaesthetic and steroid into the bursa, which often provides prompt pain relief.
• Anti-inflammatory medication – nonsteroids may ease the pain and reduce inflammation.
• Ice application at regular intervals throughout the day, 8 times daily, for about 15 minutes each time.
• Cold or Low Level Laser Therapy should be used if you require an Effective and fast Treatment.

 (View our Cold or Low Level Laser in the pain relief section.)